Working class matters: socioeconomic disadvantage, race/ethnicity, gender, and smoking in NHIS 2000.

OBJECTIVES We sought to describe the burden of smoking on the US population, using diverse socioeconomic measures. METHODS We analyzed data from the 2000 National Health Interview Survey. RESULTS Overall, the prevalence of current smoking was greatest among persons in--and independently associated with--working class jobs, low educational level, and low income. Attempts to quit showed no socioeconomic gradient, while success in quitting was greatest among those with the most socioeconomic resources. These patterns held in most but not all race/ethnicity-gender groups. Finer resolution of smoking patterns was obtained using a relational UK occupational measure, compared to the skill-based measure commonly used in US studies. CONCLUSIONS Reducing social disparities in smoking requires attention to the complexities of class along with race/ethnicity and gender.

[1]  N. Smelser,et al.  America becoming : racial trends and their consequences , 2000 .

[2]  P. Sorlie,et al.  Validity of education information on the death certificate. , 1996, Epidemiology.

[3]  Anthony D. LaMontagne,et al.  A comprehensive worksite cancer prevention intervention: behavior change results from a randomized controlled trial (United States) , 2004, Cancer Causes & Control.

[4]  J. Himmelstein,et al.  A Model for Worksite Cancer Prevention: Integration of Health Protection and Health Promotion in the WellWorks Project , 1995, American journal of health promotion : AJHP.

[5]  N. Krieger,et al.  Women and social class: a methodological study comparing individual, household, and census measures as predictors of black/white differences in reproductive history. , 1991, Journal of epidemiology and community health.

[6]  J. Leigh Occupations, cigarette smoking, and lung cancer in the epidemiological follow-up to the NHANES I and the California Occupational Mortality Study. , 1996, Bulletin of the New York Academy of Medicine.

[7]  J. Schwartz,et al.  Job Strain and Health Behaviors: Results of a Prospective Study , 1998, American journal of health promotion : AJHP.

[8]  N. Krieger Does racism harm health? Did child abuse exist before 1962? On explicit questions, critical science, and current controversies: an ecosocial perspective. , 2003, American journal of public health.

[9]  D. Silverman,et al.  Smoking patterns by occupation and duration of employment. , 1990, American journal of industrial medicine.

[10]  J. Ockene,et al.  Double Jeopardy: Workplace Hazards and Behavioral Risks for Craftspersons and Laborers , 1996, American journal of health promotion : AJHP.

[11]  S. Cochran,et al.  Classification of race and ethnicity: implications for public health. , 2003, Annual review of public health.

[12]  T. Sterling,et al.  The confounding of occupation and smoking and its consequences. , 1990, Social science & medicine.

[13]  David Satcher,et al.  Women and smoking: a report of the Surgeon General. , 2002, Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco.

[14]  M. Pflanz,et al.  Social Epidemiology , 2005 .

[15]  David R. Williams Racial/ethnic variations in women's health: the social embeddedness of health. , 2002, American journal of public health.

[16]  Stella M. Yu Healthy People 2010 , 1998, Maternal and Child Health Journal.

[17]  A question of balance: health behaviour and work context among male Glaswegians , 1992 .

[18]  Chris J. Skinner,et al.  Analysis of complex surveys , 1991 .

[19]  K. Emmons,et al.  Do Social Influences Contribute to Occupational Differences in Quitting Smoking and Attitudes toward Quitting? , 2002, American journal of health promotion : AJHP.

[20]  Injury rates by industry 1970, BLS Report 406, Department of Labor, Bureau of Labor Statistics. , 1972, IMS, Industrial medicine and surgery.

[21]  G. Johansson,et al.  Smoking and sedentary behavior as related to work organization. , 1991, Social science & medicine.

[22]  E. Parsons,et al.  Income, Social Stratification, Class, and Private Health Insurance: A Study of the Baltimore Metropolitan Area , 1996, International journal of health services : planning, administration, evaluation.

[23]  M. Fiore,et al.  Cigarette smoking prevalence by occupation in the United States. A comparison between 1978 to 1980 and 1987 to 1990. , 1994, Journal of occupational medicine. : official publication of the Industrial Medical Association.

[24]  R. Brackbill,et al.  Smoking characteristics of US workers, 1978-1980. , 1988, American journal of industrial medicine.

[25]  D. Kleinbaum,et al.  Applied Regression Analysis and Other Multivariate Methods , 1978 .

[26]  N. Krieger,et al.  Racism, sexism, and social class: implications for studies of health, disease, and well-being. , 1993, American journal of preventive medicine.

[27]  David R. Williams,et al.  Measuring social class in US public health research: concepts, methodologies, and guidelines. , 1997, Annual review of public health.

[28]  T. Sterling,et al.  Smoking characteristics by type of employment. , 1976, Journal of occupational medicine. : official publication of the Industrial Medical Association.

[29]  Richard J. Thomas Occupational Health???Recognizing and Preventing Work-Related Disease and Injury, 4th Ed. , 2000 .

[30]  Michael Marmot,et al.  Resource Reviews Social Determinants of Health , 2000 .

[31]  B Barnwell,et al.  SUDAAN User's Manual: Software for Analysis of Correlated Data, Release 6.40, , 1995 .

[32]  E. O. Wright Class Counts: Comparative Studies in Class Analysis , 1996 .

[33]  J S Avrunin,et al.  The effects of a health promotion-health protection intervention on behavior change: the WellWorks Study. , 1998, American journal of public health.

[34]  K. Bang,et al.  Prevalence of cigarette smoking by occupation and industry in the United States. , 2001, American journal of industrial medicine.

[35]  Cigarette smoking among adults--United States, 1993. , 1994, MMWR. Morbidity and mortality weekly report.

[36]  J. Johnson,et al.  The effects of psychosocial work organization on patterns of cigarette smoking among male chemical plant employees. , 1990, American journal of public health.

[37]  H. Graham Promoting health against inequality: using research to identify targets for intervention — a case study of women and smoking , 1998 .